How undocumented construction workers in B.C. put their health at risk

The housing crisis in B.C. is acute, the construction industry is booming, and the demand for workers has gone through the roof. Illegal foreign workers are filling the shortage of labour positions across the province.

They build the new, expensive high-rises and houses. In some cases, they do it for less than minimum wage or they don’t get their money at all. They are paid in cash and hired for short periods of time, which makes the transactions untraceable. The companies that employ them don’t pay taxes or mandatory premiums.

Illegal construction workers do not have medical coverage. According to WorkSafeBC, the industry has the highest number of work-related incidents and injuries in the province. When a worker without medical insurance gets hurt, they have few options. A lot of them do not access healthcare because they’re afraid they will be reported to the Canada Border Services Agency, putting them at risk of being deported.

Ambulances and hospitals in B.C. will not deny medical care to anyone who needs it, but just a ride in an ambulance is $530 and each visit to the emergency room can cost non-residents around $750.

“We operate on a full-cost recovery basis for non-residents to support sustainability of the health care system into the future,” said Fraser Health Authority spokesperson Dixon Tam.

“The rates are set by the ministry of health and apply to care provided throughout the province. We know this can cause a financial hardship on people, so we strongly encourage anyone travelling to look into health insurance.”

Steep hospital fees for those with no MSP

The fees are out of reach for most undocumented workers, and some wait until they have a life-threatening medical problem before calling 911 or going to the ER.

They earn, on average, $13 per hour for general labour positions and often can barely afford rent and food.

The Providence Health website lists some costs per day for non-insured residents and non-residents.

About $1,280 will cover the transport and admission to the ER, but diagnostic and testing fees are extra.

If the injury requires acute care, it costs $3,675 per night. And if workers require intensive care, they will be billed $10,290 for each day they are in the unit.

‘The bills are horrifying’

Construction safety officers, or CSOs, are the first – and sometimes last – point of contact when an undocumented worker gets hurt. They provide first aid and are in charge of monitoring the safety of job sites.

Maria Lule is a CSO who works at a job site in Vancouver. She has been in the industry for more than 10 years. She tries to pay special attention to undocumented workers because she knows about the risks and consequences if they get hurt.

“There are many that come from Mexico without medical coverage. The bills are horrifying,” Lule said. “You could end up having $50,000 in debt at the [Vancouver General Hospital]. If they know you can’t pay, they won’t charge you right away, but it will for sure go on your file.”

Maria Lule (Photo by Natalia Buendia Calvillo).

She recalled a situation where a drywall worker got hurt at one of her sites. He had to lie at the clinic and say it happened at home because medical professionals are required to report workplace injuries.

“Even if they did have insurance, most likely is that they will not declare where it happened because the health authorities would investigate,” she said.

“This situation is like a pink elephant in the room. The government knows that is going on. Any officer knows that if they walk onto a construction site, they can arrest someone.”

Lule said the hardest part is seeing how some young workers risk their health by doing dangerous tasks. Some get hired without proper safety training, and others do not wear all the required protective equipment.

“One of the first rules that [Workers Compensation Branch] has is to not be exposed to drilled concrete without protection,” said Lule. “Sometimes, they only wear a simple facemask.”

Alternatives to having to pay out of pocket

Alternatives to accessing health care means reaching out to providers who are willing to work for free or for a reduced fee.

Byron Cruz is an outreach worker for Sanctuary Health, an advocacy organization that helps migrant workers access health care and other social services despite their immigration status. The organization and Cruz’s cellphone number are known as the ‘911’ of undocumented workers.

“We sometimes get to the point where we can’t find a doctor to do stitches, but there is a veterinarian in the community who says, ‘I can do it!’” said Cruz.

The first time he noticed an increase in undocumented workers was in the lead-up to the 2010 Olympics in Vancouver when the Canada Line and Olympic Village were being built.

“The city, the businesses, they all needed to have the village ready before the Olympics started,” Cruz said. “Canada Line had to be ready.”

In other cases, undocumented workers with mild injuries rely on co-workers who are trained as physiotherapists, dentists or doctors. Without insurance, even a simple toothache can present a health risk.

Byron Cruz from Sanctuary Health, an organization who advocates for migrant health. Photo taken at a community garden in East Vancouver (Photo by Natalia Buendia Calvillo).

Cruz said widespread violence and political corruption in Mexico are pushing unemployed young professionals to come to Canada and work in construction. Many of them are from middle-class families looking for better opportunities and they have to adapt to a different lifestyle.

“When they come here, they come to live in houses where 15 people live where a bathtub turns into a bed, a closet into another sleeping area,” he said. “And they live all together because, obviously, the housing crisis pushes them to do that.”

Nell Toussaint is a citizen of Grenada who arrived in 1999, overstayed her permit and worked illegally in the country for more than six years.

Her health started to deteriorate. After being denied tests because of lack of insurance or funds, and not receiving proper medical care, she developed a pulmonary embolism.

She was the first undocumented worker who challenged the court’s decision for not providing accessible medical care to people with illegal immigration status.

Toussaint ultimately lost before the courts, but argued that denying a person from medical care breaches the Charter of Rights and Freedoms.

She eventually obtained permanent residence and medical care, but still took the issue to the United Nations Human Rights committee.

Recently, the committee concluded that Canada violated the human rights of Toussaint and she deserves compensation from the government. Ottawa is currently reviewing that decision.